Organization
DYNACARE NORTHWEST INC.
Active
Other names
Issaquah Stat Lab
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY WILLIAMS (VP)
(800) 222-7566
Entity
Organization
Contact information
Practice address
450 NW GILMAN BLVD STE 101, ISSAQUAH, WA 98027-2483
(425) 391-0752
Mailing address
PO BOX 2240, BURLINGTON, NC 27216-2240
(800) 222-7566
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50D1017881
CLIA
—
Enumeration date
07/28/2008
Last updated
12/23/2013
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